Search results for: long term conditions

Authors: Peter Brink

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Much of the research examining sexuality in long-term care focus on individual experiences, specifically their past, present, and future lived experiences. We know little about long-term care home policies, how they relate to the LGBT community, or how accommodating long-term care homes are to the LGBT+ community. In many ways, residents who identify as LGBT+ have been invisible in long-term care homes. Up until the not-to-distant past, homosexuality was illegal, and discrimination was acceptable. Canada’s LGBT population has also suffered because of the HIV/AIDS epidemic. For these and other reasons, members of the LGBT community might resist entering long-term care or attempt to keep their sexuality secret. The goal of any long-term care home is to be a welcoming place, to display signs of inclusion, and to help residents and staff feel that they are embraced. From the perspective of the long-term care home, it is possible that many of these facilities do not necessarily see the need to mention gender identity or sexual orientation in their welcoming materials. However, from the perspective of the invisible minority, it may be important that these homes be more than just welcoming. This study examined the role of institutional policies in long-term care for residents who identify as LGBT.

Keywords: long-term care, LGBT, HIV/AIDS, policy

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Authors: Shu-Yu Chung, Ying-Fang Wang, Shih-Min Wang

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To conduct long-term exposure assessments are important for workers exposed to chemicals with chronic effects. However, it usually encounters with several constrains, including cost, workers' willingness, and interference to work practice, etc., leading to inadequate long-term exposure data in the real world. In this study, an integrated approach was developed for conducting long-term exposure assessment for welding workers in a shipbuilding factory. A laboratory study was conducted to yield the fume generation rates under various operating conditions. The results and the measured environmental conditions were applied to the near field/far field (NF/FF) model for predicting long term fume exposures via the Monte Carlo simulation. Then, the predicted long-term concentrations were used to determine the prior distribution in Bayesian decision analysis (BDA). Finally, the resultant posterior distributions were used to assess the long-term exposure and serve as basis for initiating control strategies for shipbuilding workers. Results show that the NF/FF model was a suitable for predicting the exposures of metal contents containing in welding fume. The resultant posterior distributions could effectively assess the long-term exposures of shipbuilding welders. Welders' long-term Fe, Mn and Pb exposures were found with high possibilities to exceed the action level indicating preventive measures should be taken for reducing welders' exposures immediately. Though the resultant posterior distribution can only be regarded as the best solution based on the currently available predicting and monitoring data, the proposed integrated approach can be regarded as a possible solution for conducting long term exposure assessment in the field.

Keywords: Bayesian decision analysis, exposure assessment, near field and far field model, shipbuilding industry, welding fume

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Authors: Hrachuhi Galstyan, Lucian Sfîcă, Pavel Ichim

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The purpose of this study is to analyze the temporal and spatial variability of thermal conditions in the Republic of Armenia. The paper describes annual fluctuations in air temperature. Research has been focused on case study region of Armenia and surrounding areas, where long–term measurements and observations of weather conditions have been performed within the National Meteorological Service of Armenia and its surrounding areas. The study contains yearly air temperature data recorded between 1961-2012. Mann-Kendal test and the autocorrelation function were applied to detect the change trend of annual mean temperature, as well as other parametric and non-parametric tests searching to find the presence of some breaks in the long term evolution of temperature. The analysis of all records reveals a tendency mostly towards warmer years, with increased temperatures especially in valleys and inner basins. The maximum temperature increase is up to 1,5 °C. Negative results have not been observed in Armenia. The patterns of temperature change have been observed since the 1990’s over much of the Armenian territory. The climate in Armenia was influenced by global change in the last 2 decades, as results from the methods employed within the study.

Keywords: air temperature, long-term variability, trend, climate change

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Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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Authors: Liu Yi-Hui, Chiu Fan-Yun, Lin Yu Fang, Jhang Yu Cih, He You Jing

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The demand for care support has been rising with the aging of society and the advancement of medical science and technology. To meet rising demand, the Taiwanese government promoted the “Long Term Care Ten-Year Plan 2.0” in 2017. However, this policy and its related services failed to be fully implemented because of the ignorance of the public, and their lack of desire, fear, or discomfort in using them, which is a major obstacle to the promotion of long-term care services. Given the above context, this research objectives included the following: (1) to understand the current situation and predicament of family caregivers; (2) to reveal the actual use and assistance of government’s long-term care resources for family caregivers; and (3) to explore the support and impact of social capital on family caregivers. A semi-structured in-depth interview with five family caregivers to understand long-term care networks and social capital for family caregivers.

Keywords: family caregivers, long-term care, social capital

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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Authors: Lenka Matulova

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Geopolymers are alumosilicate materials that have long been studied. Despite this fact, little is known about the long-term stability of geopolymer mechanical and structural properties, so crucial for their successful industrial application. To improve understanding, we investigated the effect of four different types of environments on the mechanical and structural properties of a metakaolin-based geopolymer (MK GP). The MK GP samples were stored in laboratory conditions (control samples), in water at 20 °C, in water at 80 °C, and outside exposed to the weather. Compressive and tensile strengths were measured after 28, 56, 90, and 360 days. In parallel, structural properties were analyzed using XRD, SEM, and mercury intrusion porosimetry. Whereas the mechanical properties of the samples in laboratory conditions and in 20 °C water were stable, the mechanical properties of the outdoor samples and the samples 80 °C water decreased noticeably after 360 days. Structural analyses were focused on changes in sample microstructure (developing microcrack network, porosity) and identifying zeolites, the presence of which would indicate detrimental processes in the structure that can change it from amorphous to crystalline. No zeolites were found during the 360-day period in MK GP samples, but the reduction in mechanical properties coincided with a developing network of microcracks and changes in pore size distribution.

Keywords: geopolymer, long-term properties, mechanical properties, metakaolin, structural properties

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Authors: Teguh Sugiarto, Ahmad Subagyo, Ludiro Madu, Amir Mohammadian Amiri

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Recently, the significant fluctuations accosiated with Indonesian economy justifies the need for paying more attention to this issue. In this regard, the main objective of this study is to investigate the relationship between two issues related to the macro Indonesia economy called consumption and GDP during the period of 1967 to 2014. This research method exploits short term and long term relationships using Granger and subsequently, models them by the causality method . However, using analysis of Granger with Johansen shows that there is not only a long term, but also a short-long relationship between GDP and consumption using lags the interval 5.

Keywords: cointegration, Granger causality, GDP, consumption

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Authors: Qingyu Zhang, Mei Cao

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As the environments become increasingly uncertain, firms have attempted to achieve greater supply chain collaboration. Supply chain collaboration can generate significant benefits to its members, e.g., reducing risks and decreasing transaction costs. However, a strong relationship is often related to firm’s culture (e.g., short-term vs. long-term interests). The objective of the study is to explore the effect of long-term oriented culture on product quality in a supply chain. Data was collected through a Web survey of U.S. manufacturing firms. Structural equation modeling (LISREL) was used to analyze the data. The results support the mediating roles of goal congruence and communication in the relationship between long-term orientation and product quality in the supply chain. Goal congruence partially mediates the relationship between long-term orientation and communication; communication completely mediates the relationship between goal congruence and product quality. Without high levels of communication, goal congruence cannot improve product quality in a positive way.

Keywords: communication, long-term orientation, product quality, supply chain

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Authors: Mehrnaz Alibeikloo, Hajar Share Isfahani, Hadi Khabbaz

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In recent years, by developing cities and increasing population, reconstructing on closed landfill sites in some regions is unavoidable. Long-term settlement is one of the major concerns associated with reconstruction on landfills after closure. The purpose of this research is evaluating the effect of preloading in various patterns of height and time on long-term settlements of closed landfills. In this regard, five scenarios of surcharge from 1 to 3 m high within 3, 4.5 and 6 months of preloading time have been modeled using PLAXIS 2D software. Moreover, the numerical results have been compared to those obtained from analytical methods, and a good agreement has been achieved. The findings indicate that there is a linear relationship between settlement and surcharge height. Although, long-term settlement decreased by applying a longer and higher preloading, the time of preloading was found to be a more effective factor compared to preloading height.

Keywords: preloading, long-term settlement, landfill, PLAXIS 2D

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Authors: Hong Fan, Lifang Gao, Feng Zhan

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This paper examines the influence of local gambling attitudes on a firm's long-term financial performance. Firms located in gambling-prone regions may be more willing to take risks, thus spending more on innovative projects. However, firms in such regions may also be likely to choose projects impulsively and allocate resources inefficiently. By studying Chinese publicly listed firms from 2010 to 2017, we find that firms in more gambling-prone regions invest more in R&D. Both local gambling attitudes and firms’ R&D spending are positively associated with firms’ long-term financial performance. More importantly, our study reveals that the positive impact of R&D spending on firms’ long-term financial performance is weakened by gambling-friendly attitudes, probably because firms in gambling-prone regions are more likely to overinvest in risky projects. This effect is stronger for larger firms, state-owned enterprises (SOEs), firms with more government subsidies, and firms with weaker internal control.

Keywords: regional gambling attitudes, long-term financial performance, R&D, risk, local bias

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Authors: Palaniraj Rama Raj, Himeesh Kumar, Paul Adler

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Purpose: To investigate the effect of ultrasound energy, expressed as cumulative dissipated energy (CDE), on short and long-term outcomes after uncomplicated cataract surgery by phacoemulsification. Methods: In this single-surgeon, two-center retrospective study, non-glaucomatous participants who underwent uncomplicated cataract surgery were investigated. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured at 3 separate time points: pre-operative, Day 1 and ≥1 month. Anterior chamber (AC) inflammation and corneal odema (CO) were assessed at 2 separate time points: Pre-operative and Day 1. Short-term changes (Day 1) in BCVA, IOP, AC and CO and long-term changes (≥1 month) in BCVA and IOP were evaluated as a function of CDE using a multivariate multiple linear regression model, adjusting for age, gender, cataract type and grade, preoperative IOP, preoperative BCVA and duration of long-term follow-up. Results: 110 eyes from 97 non-glaucomatous participants were analysed. 60 (54.55%) were female and 50 (45.45%) were male. The mean (±SD) age was 73.40 (±10.96) years. Higher CDE counts were strongly associated with higher grades of sclerotic nuclear cataracts (p <0.001) and posterior subcapsular cataracts (p <0.036). There was no significant association between CDE counts and cortical cataracts. CDE counts also had a positive correlation with Day 1 CO (p <0.001). There was no correlation between CDE counts and Day 1 AC inflammation. Short-term and long-term changes in post-operative IOP did not demonstrate significant associations with CDE counts (all p >0.05). Though there was no significant correlation between CDE counts and short-term changes in BCVA, higher CDE counts were strongly associated with greater improvements in long-term BCVA (p = 0.011). Conclusion: Though higher CDE counts were strongly associated with higher grades of Day 1 postoperative CO, there appeared to be no detriment to long-term BCVA. Correspondingly, the strong positive correlation between CDE counts and long-term BCVA was likely reflective of the greater severity of underlying cataract type and grade. CDE counts were not associated with short-term or long-term postoperative changes in IOP.

Keywords: cataract surgery, phacoemulsification, cumulative dissipated energy, CDE, surgical outcomes

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Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: Reinhard Haas, Amela Ajanovic

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In recent years especially electricity generation from intermittent sources like wind and solar has increased remarkably. To balance electricity supply over time calls for storages has been launched. Because intermittency also exists over longer periods – months, years, especially the need for long-term electricity storages is discussed. The major conclusions of our analysis are: (i) Despite many calls for a prophylactic construction of new storage capacities with respect to all centralized long-term storage technologies the future perspectives will be much less promising than currently indicated in several papers and discussions; (ii) new long term hydro storages will not become economically attractive in general in the next decades; however, daily storages will remain the cheapest option and the most likely to be competitive; (iii) For PtG-technologies it will also become very hard to compete in the electricity markets despite a high technological learning potential. Yet, for hydrogen and methane there are prospects for use in the transport sector.

Keywords: storages, electricity markets, power-to-gas, hydro pump storages, economics

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Authors: Thang V. Kieu, Long P. Nguyen

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Kernelized Correlation Filter (KCF) based trackers have gained a lot of attention recently because of their accuracy and fast calculation speed. However, this algorithm is not robust in cases where the object is lost by a sudden change of direction, being obscured or going out of view. In order to improve KCF performance in long-term tracking, this paper proposes an anomaly detection method for target loss warning by analyzing the response map of each frame, and a classification algorithm for reliable target re-locating mechanism by using Random fern. Being tested with Visual Tracker Benchmark and Visual Object Tracking datasets, the experimental results indicated that the precision and success rate of the proposed algorithm were 2.92 and 2.61 times higher than that of the original KCF algorithm, respectively. Moreover, the proposed tracker handles occlusion better than many state-of-the-art long-term tracking methods while running at 60 frames per second.

Keywords: correlation filter, long-term tracking, random fern, real-time tracking

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Authors: Farheen Akram

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Research and Development (R&D) is the most crucial element of the firm’s survival in a competitive business environment. R&D is a long-term investment; therefore, executives having the power to make the investment decisions may be pessimistic when their compensation is closely linked with short-term firm performance. Thus, the current study investigates the impact of board composition and executives’ compensation (cash or short-term benefits and LTIs) on R&D spending using a sample of 85 S&P/100 firms listed on the Australian Stock Exchange (ASX) in 2017. SmartPLS (v.3.2.7) was used to evaluate the proposed model of current research. The empirical findings of this study indicate that board composition has a significant and positive effect on R&D spending. While, as expected, executive cash compensation has negative and Long-Term-Incentives (LTIs) has a positive impact on R&D spending. Based on current findings, the study suggested that myopic behavior of CEOs and top management towards long-term value creation investment like R&D can be controlled by using long-term compensation rewards.

Keywords: cash compensation, LTIs, board composition, R&D spending

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Authors: Jun Hee Lee, Young Kyu Kim, Seong Jae Hong, Chamroeun Chhorn, Seung Woo Lee

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Roller-compacted concrete pavement (RCCP), an environmental friendly pavement of which load carry capacity benefitted from both hydration and aggregate interlock from roller compacting, demonstrated a superb structural performance for a relatively small amount of water and cement content. Even though an excellent structural performance can be secured, it is required to investigate roller-compacted concrete (RCC) under environmental loading and its long-term durability under critical conditions. In order to secure long-term durability, an appropriate internal air-void structure is required for this concrete. In this study, a method for improving the long-term durability of RCCP is suggested by analyzing the internal air-void structure and corresponding durability of RCC. The method of improving the long-term durability involves measurements of air content, air voids, and air-spacing factors in RCC that experiences changes in terms of type of air-entraining agent and its usage amount. This test is conducted according to the testing criteria in ASTM C 457, 672, and KS F 2456. It was found that the freezing-thawing and scaling resistances of RCC without any chemical admixture was quite low. Interestingly, an improvement of freezing-thawing and scaling resistances was observed for RCC with appropriate the air entraining (AE) agent content; Relative dynamic elastic modulus was found to be more than 80% for those mixtures. In RCC with AE agent mixtures, large amount of air was distributed within a range of 2% to 3%, and an air void spacing factor ranging between 200 and 300 μm (close to 250 μm, recommended by PCA) was secured. The long-term durability of RCC has a direct relationship with air-void spacing factor, and thus it can only be secured by ensuring the air void spacing factor through the inclusion of the AE in the mixture.

Keywords: durability, RCCP, air spacing factor, surface scaling resistance test, freezing and thawing resistance test

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Authors: İrem Bulut, Mustafa Z. Söyük, Ertuğrul Yalçın, Simge Şişman-Bal

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Eyewitness testimony is one of the most frequently used methods in criminal cases for the determination of crime and perpetrator. In the literature, the number of studies about the reliability of eyewitness testimony is increasing. The study aims to reveal the factors that affect the short-term and long-term visual memory performance of the participants in the event of an accident. In this context, the effect of the emotional content of the accident and the sounds during the accident on visual memory performance was investigated with eye-tracking. According to the results, the presence of visual and auditory stimuli with emotional content during the accident decreases the participants' both short-term and long-term recall performance. Moreover, the data obtained from the eye monitoring device showed that the participants had difficulty in answering even the questions they focused on at the time of the accident.

Keywords: eye tracking, eyewitness testimony, long-term recall, short-term recall, visual memory

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Authors: Xiuying Wang, Changliang Li, Bo Xu

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A fixed-length feature vector is required for many machine learning algorithms in NLP field. Word embeddings have been very successful at learning lexical information. However, they cannot capture the compositional meaning of sentences, which prevents them from a deeper understanding of language. In this paper, we introduce a novel hierarchical tree long short-term memory (HTLSTM) model that learns vector representations for sentences of arbitrary syntactic type and length. We propose to split one sentence into three hierarchies: short phrase, long phrase and full sentence level. The HTLSTM model gives our algorithm the potential to fully consider the hierarchical information and long-term dependencies of language. We design the experiments on both English and Chinese corpus to evaluate our model on sentiment analysis task. And the results show that our model outperforms several existing state of the art approaches significantly.

Keywords: deep learning, hierarchical tree long short-term memory, sentence representation, sentiment analysis

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Authors: Wei Gao

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The current study investigates the change of listener responses in social conversations of the second language (L2) speakers who are staying abroad with Chinese L1 speakers in Australian universities and how their long-term stay abroad impacted their design for L2 recipient actions. There is a limited amount of empirical work on L2 English listener response acquisition, particularly regarding the influence of long-term stay abroad in English-speaking countries. Little is known whether the development of L2 listener responses and the improvement of interactional competence is affected by the prolonged residency in the target L2 country. Forty-eight participants were recruited, and they participated in the designed speaking task through Computer-Mediated Communication. Results showed that long-term stay abroad Chinese L1 speakers demonstrated an English-like pattern of listener responses in communication. Long-term stay abroad experience had a significant impact on L2 English listener responses production and organization in social conversation. Long-term stay abroad L1 Chinese speakers had an active and productive response in listenership than their non-stay abroad counterparts in terms of frequency and placement in producing listener responses. However, the L2 English listener response production only occurred to be partial in response tokens, such as backchannels and reactive expressions, also in resumptive openers' employment. This study shows that L2 English listener responses could be acquired during a long-term stay abroad in English-speaking countries but showed partial acquisition in collaborative finishes production. In addition, the most prominent finding was that Chinese L1 speakers changed their overall listener responses pattern from L1 Chinese to L2 English. The study reveals specific interactional changes in English L2 listener responses acquisition. It generates pedagogical implications for cross-cultural communication and L2 pragmatics acquisition during a long-term stay abroad.

Keywords: listener responses, stay abroad, interactional competence, L2 pragmatics acquisition

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Bharatendra Rai

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The sequence of words in text data has long-term dependencies and is known to suffer from vanishing gradient problems when developing deep learning models. Although recurrent networks such as long short-term memory networks help to overcome this problem, achieving high text classification performance is a challenging problem. Convolutional recurrent networks that combine the advantages of long short-term memory networks and convolutional neural networks can be useful for text classification performance improvements. However, arriving at suitable hyperparameter values for convolutional recurrent networks is still a challenging task where fitting a model requires significant computing resources. This paper illustrates the advantages of using convolutional recurrent networks for text classification with the help of statistically planned computer experiments for hyperparameter tuning.

Keywords: long short-term memory networks, convolutional recurrent networks, text classification, hyperparameter tuning, Tukey honest significant differences

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Authors: Kambiz Rasoulkhani, Jeanne Cole, Sybil Sharvelle, Ali Mostafavi

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Dual water distribution systems have been proposed as solutions to enhance the sustainability and resilience of urban water systems by improving performance and decreasing energy consumption. The objective of this study was to evaluate the long-term resilience and robustness of dual water distribution systems versus singular water distribution systems under various stressors such as demand fluctuation, aging infrastructure, and funding constraints. To this end, the long-term dynamics of these infrastructure systems was captured using a simulation model that integrates institutional agency decision-making processes with physical infrastructure degradation to evaluate the long-term transformation of water infrastructure. A set of model parameters that varies for dual and singular distribution infrastructure based on the system attributes, such as pipes length and material, energy intensity, water demand, water price, average pressure and flow rate, as well as operational expenditures, were considered and input in the simulation model. Accordingly, the model was used to simulate various scenarios of demand changes, funding levels, water price growth, and renewal strategies. The long-term resilience and robustness of each distribution infrastructure were evaluated based on various performance measures including network average condition, break frequency, network leakage, and energy use. An ecologically-based resilience approach was used to examine regime shifts and tipping points in the long-term performance of the systems under different stressors. Also, Classification and Regression Tree analysis was adopted to assess the robustness of each system under various scenarios. Using data from the City of Fort Collins, the long-term resilience and robustness of the dual and singular water distribution systems were evaluated over a 100-year analysis horizon for various scenarios. The results of the analysis enabled: (i) comparison between dual and singular water distribution systems in terms of long-term performance, resilience, and robustness; (ii) identification of renewal strategies and decision factors that enhance the long-term resiliency and robustness of dual and singular water distribution systems under different stressors.

Keywords: complex systems, dual water distribution systems, long-term resilience performance, multi-agent modeling, sustainable and resilient water systems

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Authors: Belloufi Mohammed, Sellami Badreddine

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This paper deals with a new nonlinear modified three-term conjugate gradient algorithm for solving large-scale unstrained optimization problems. The search direction of the algorithms from this class has three terms and is computed as modifications of the classical conjugate gradient algorithms to satisfy both the descent and the conjugacy conditions. An example of three-term conjugate gradient algorithm from this class, as modifications of the classical and well known Hestenes and Stiefel or of the CG_DESCENT by Hager and Zhang conjugate gradient algorithms, satisfying both the descent and the conjugacy conditions is presented. Under mild conditions, we prove that the modified three-term conjugate gradient algorithm with Wolfe type line search is globally convergent. Preliminary numerical results show the proposed method is very promising.

Keywords: unconstrained optimization, three-term conjugate gradient, sufficient descent property, line search

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Authors: N. Musayeva, N. Rustamova, N. Bagirov, S. Ibadov

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Purpose: to analyze the long-term results of external dacryocystorhinostomy (DCR), which remains the preferred primary procedure in the surgical treatment of lacrimal duct obstruction in chronic dacryocystitis. Methodology: long-term results of external DCR (after 3 years) performed on 90 patients (90 eyes) with chronic dacryocystitis from 2018 to 2020 were evaluated. The Azerbaijan National Center of Ophthalmology, named after acad. Zarifa Aliyeva. 15 of the patients were men, 75 – women. The average age was 45±3.2 years. Surgical operations were performed under local anesthesia. All patients suffered from diabetes mellitus for more than 3 years. All patients underwent external DCR and silicone drainage (tube) was implanted. In the postoperative period (after 3 years), lacrimation, purulent discharge, and the condition of the scar at the operation site were assessed. Results: All patients were under observation for more than 18 months. In general, the effectiveness of the surgical operation was 93.34%. Recurrence of disease was observed in 6 patients and in 3 patients (3.33%), the scar at the site of the operation was rough (non-cosmetic). In 3 patients (3.33%) – the surgically formed anastomosis between the lacrimal sac and the nasal bone was obstructed by scar tissue. These patients were reoperated by trans canalicular laser DCR. Conclusion: Despite the long-term (more than a hundred years) use of external DCR, it remains one of the primary techniques in the surgery of chronic dacryocystitis. Due to the high success rate and good long-term results of DCR in the treatment of chronic dacryocystitis in patients suffering from diabetes mellitus, we recommend external DCR for this group of patients.

Keywords: chronic dacryocystitis, diabetes mellitus, external dacryocystorhinostomy, long-term results

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Authors: Aruha Khan, Brynn E. Kankel, Paraskevi Papadopoulou

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In recent years, extensive research upon ‘stress’ has provided insight into its two distinct guises, namely the short–term (fight–or–flight) response versus the long–term (chronic) response. Specifically, the long–term or chronic response is associated with the suppression or dysregulation of immune function. It is also widely noted that the occurrence of cancer is greatly correlated to the suppression of the immune system. It is thus necessary to explore the impact of long–term or chronic stress upon the prevalence and risk of cancer. To what extent can the dysregulation of immune function caused by long–term exposure to stress be controlled or minimized? This study focuses explicitly upon immunosuppression due to its ability to increase disease susceptibility, including cancer itself. Based upon an analysis of the literature relating to the fundamental structure of the immune system alongside the prospective linkage of chronic stress and the development of cancer, immunosuppression may not necessarily correlate directly to the acquisition of cancer—although it remains a contributing factor. A cross-sectional analysis of the survey data from the University of Tennessee Medical Center (UTMC) and Harvard Medical School (HMS) will provide additional supporting evidence (or otherwise) for the hypothesis of the study about whether immunosuppression (caused by the chronic stress response) notably impacts the prevalence of cancer. Finally, a multidimensional framework related to education on chronic stress and its effects is proposed.

Keywords: immune system, immunosuppression, long–term (chronic) stress, risk of cancer

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

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Authors: L. Totladze

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The role of financial sector in supporting economic growth and development is well acknowledged. The term spread (the difference between the yields on long-term and short-term Treasury securities) has been found useful for predicting economic variables as output growth, inflation, industrial production, consumption. The temp spread is one of the leading economic indicators according to NBER methodology. Leading economic indicators are widely used in forecasting of economic activity. Many empirical studies find that the term spread predicts future economic activity. The article shortly explains how the term spread might predict future economic activity. This paper analyses the dynamics of the spread between short and long-term interest rates in countries with transition economies. The research paper analyses term spread dynamics in Georgia and compare it with post-communist countries and transition economies spread dynamics. In Georgia, the banking sector plays an important and dominant role in the financial sector, especially with respect to the mobilization of savings and provision of credit and may impact on economic activity. For this purpose, we study the impact of the term spread on economic growth in Georgia.

Keywords: forecasting, leading economic indicators, term spread, transition economies

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Authors: Sandra Rigot, Samira Demaria, Frederic Lemaire

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The starting point of this research is the contemporary capitalist paradox: there is a real scarcity of long term investment despite the boom of potential long term investors. This gap represents a major challenge: there are important needs for long term financing in developed and emerging countries in strategic sectors such as energy, transport infrastructure, information and communication networks. Moreover, the recent financial and sovereign debt crises, which have respectively reduced the ability of financial banking intermediaries and governments to provide long term financing, questions the identity of the actors able to provide long term financing, their methods of financing and the most appropriate forms of intermediation. The issue of long term financing is deemed to be very important by the EU Commission, as it issued a 2013 Green Paper (GP) on long-term financing of the EU economy. Among other topics, the paper discusses the impact of the recent regulatory reforms on long-term investment, both in terms of accounting (in particular fair value) and prudential standards for banks. For banks, prudential and accounting standards are also crucial. Fair value is indeed well adapted to the trading book in a short term view, but this method hardly suits for a medium and long term portfolio. Banks’ ability to finance the economy and long term projects depends on their ability to distribute credit and the way credit is valued (fair value or amortised cost) leads to different banking strategies. Furthermore, in the banking industry, accounting standards are directly connected to the prudential standards, as the regulatory requirements of Basel III use accounting figures with prudential filter to define the needs for capital and to compute regulatory ratios. The objective of these regulatory requirements is to prevent insolvency and financial instability. In the same time, they can represent regulatory constraints to long term investing. The balance between financial stability and the need to stimulate long term financing is a key question raised by the EU GP. Does fair value accounting contributes to short-termism in the investment behaviour? Should prudential rules be “appropriately calibrated” and “progressively implemented” not to prevent banks from providing long-term financing? These issues raised by the EU GP lead us to question to what extent the main regulatory requirements incite or constrain banks to finance long term projects. To that purpose, we study the 292 responses received by the EU Commission during the public consultation. We analyze these contributions focusing on particular questions related to fair value accounting and prudential norms. We conduct a two stage content analysis of the responses. First, we proceed to a qualitative coding to identify arguments of respondents and subsequently we run a quantitative coding in order to conduct statistical analyses. This paper provides a better understanding of the position that a large panel of European stakeholders have on these issues. Moreover, it adds to the debate on fair value accounting and its effects on prudential requirements for banks. This analysis allows us to identify some short term bias in banking regulation.

Keywords: basel 3, fair value, securitization, long term investment, banks, insurers

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